TEMPLE UNIVERSITY SCHOOL OF MEDICINE
- 1/27/2017—FIVE YEARS PROBATION WITH VARIOUS TERMS AND CONDITIONS. RESTRICTIONS: PROHIBITED FROM ENGAGING IN THE SOLO PRACTICE OF MEDICINE, PRESCRIBING, FURNISHING, AND/OR PROVIDING SAMPLES OF NARCOTICS, DANGEROUS DRUGS, AND/OR CONTROLLED SUBSTANCES TO ANY FAMILY MEMBER AND TREATING, DIAGNOSING OR COUNSELING ANY FAMILY MEMBER. NO ADMISSIONS BUT CHARGED WITH GROSS NEGLIGENCE AND FURNISHING DRUGS TO AN ADDICT IN THE CARE AND TREATMENT OF ONE PATIENT; REPEATED NEGLIGENT ACTS, PRESCRIBING DANGEROUS DRUGS WITHOUT AN APPROPRIATE EXAMINATION, EXCESSIVE PRESCRIBING, AND FAILURE TO MAINTAIN ADEQUATE AND ACCURATE RECORDS IN THE CARE AND TREATMENT OF FOUR PATIENTS; AND VIOLATION OF STATUTES REGULATING DRUGS.
- 1/26/2016—ACCUSATION FILED.
Excerpt from Accusation dated 1/26/2016:
FIRST CAUSE FOR DISCIPLINE
(Gross Negligence)
15. Respondent is subject to disciplinary action under section 2234, subdivision (b), of the Code in that he was grossly negligent in his care and treatment of patient J.C., Respondent's brother. The circumstances are as follows:
16. From approximately 2008 to 2013, Respondent was a Partner at Kaiser Permanente Department ofEmergency Medicine, Orange County.
17. Respondent did not see or treat patient J.C. at the Kaiser facility at which he was employed. However, beginning in 2011 and continuing for approximately three years, Respondent used his Kaiser prescription pads to prescribe Ambien to patient J.C. Respondent maintained no medical records for this patient.
18. The standard of care for prescribing Ambien is as follows:
- Ambien is prescribed for the short-term treatment of insomnia.
- Ambien is taken only once per night immediately before bedtime. The prescribing dosage in adults is recommended at 5 mg. for women and either 5 or 10 mg. for men. The total dose should not exceed 10 mg.
- The medication should only be prescribed after a thorough evaluation ofthe patient, and the physician should evaluate co-morbid conditions, including physical or psychiatric disorders.The physician should determine the most appropriate treatment plan for insomnia. Treatment for insomnia includes modalities other than sleeping pills, which should be prescribed when other modalities have failed.
- Ambien is a Schedule IV controlled substance which may be abused or lead to dependence. Abuse includes using the drug for non-medical purposes. Physicians should be alerted to potential abuse and should address the abuse.
19. Respondent prescribed 10 mg. Ambien to patient J.C. on multiple occasions, including the following: [See original document for data.]
20. Respondent prescribed Ambien to patient J.C. without performing an evaluation.
21. Respondent prescribed excessive amounts of Ambien without following the prescribing protocol and/or in a manner that demonstrated misuse of the medication.
22. Respondent did not refer patient J.C. to another health care professional for assistance with an apparent Ambien addiction.
23. Respondent did not screen for prior or current substance abuse or misuse.
24. Respondent was grossly negligent in his care and treatment of J.C. as follows:
- He failed to evaluate and/or document an evaluation of patient J.C. before prescribing Ambien;
- He prescribed an excessive amount of Ambien;
- He prescribed Ambien in amounts that demonstrated a non-medical purpose;
- He failed to monitor J.C.'s insomnia; and/or
- He failed to refer patient J.C. for assistance in the misuse of Ambien.
25. Respondent's acts and/or omissions in the care of patient J.C., as set forth in paragraph 24, whether proven individually or jointly, constitute gross negligence pursuant to section 2234, subdivision (b), of the Code. Therefore cause for discipline exists.
SECOND CAUSE FOR DISCIPLINE
(Repeated Negligent Acts)
26. Respondent is subject to disciplinary action under section 2234, subdivision (c), of the Code in that his care and treatment of patients constituted repeated negligent acts. The circumstances are as follows.
Patient J.C.
27. The allegations of the First Cause for Discipline are incorporated herein as if fully set forth.
Patient L.C.
28. Respondent did not see or treat patient L.C., his mother, at the Kaiser facility at which he was employed. However, Respondent used his Kaiser Prescription pads to prescribe Ambien to patient L.C. Respondent maintained no medical records for this patient.
29. Respondent prescribed 10 mg. Ambien to patient L.C. on multiple occasions, including the following: [See original document for data.]
30. Respondent prescribed Ambien to patient L.C. without performing an evaluation.
31. Respondent prescribed Ambien to patient L.C. to treat oral stomatitis, sores or inflammation ofthe mouth, which is better treated with localized medications.
32. Respondent prescribed excessive amounts of Ambien without following the prescribing protocol.
33. Respondent prescribed Ambien to patient L.C. without referring her to her own physician.
34. Respondent was negligent in his care and treatment of patient L.C. as follows:
- He failed to evaluate and/or document an evaluation o f patient L.C. before prescribing Ambien;
- He prescribed an excessive amount of Ambien and/or prescribed Ambien for an inappropriate purpose;
- He failed to monitor patient L.C.'s insomnia;
- He failed to refer patient L.C. to her own physician for treatment of insomnia.
Patient A.C.
35. Respondent did not see or treat patient A.C., his brother, at the Kaiser facility at which he was employed. However, Respondent used his Kaiser prescription pads to prescribe Ambien to patient A.C. Respondent maintained no medical records for this patient.
36. Respondent prescribed 10 mg. Ambien to patient A.C. on multiple occasions, including the following: [See original document for data.]
37. Respondent prescribed Ambien to patient A.C. without performing an evaluation.
38. Respondent prescribed excessive amounts of Ambien without following the protocol.
39. Respondent prescribed Ambien to patient A.C. without referring him to his own physician.
40.Respondent was negligent in his care and treatment of patient A.C. as follows:
- He failed to evaluate and/or document an evaluation of patient A.C. before prescribing Ambien;
- He prescribed an excessive amount of Ambien;
- He failed to monitor patient A.C.'s insomnia;
- He failed to refer patient A.C. to his own physician for treatment of insomnia.
Patient C.L.
41. During the time-period of approximately 2009 to 2014, Respondent and patient C.L., a physician, were employed together at Kaiser Permanente Department of Emergency Medicine, Orange County.
42. Respondent prescribed Ambien to patient C.L. Respondent maintained no medical records for this patient.
43. Respondent prescribed 10 mg. Ambien to patient C.L. on multiple occasions, including the following: [See original document for data.]
44. Respondent prescribed Ambien to patient C.L. without performing an evaluation.
45. Respondent did not monitor patient C.L.'s insomnia or his use of Ambien.
46. Respondent was negligent in his care and treatment of patient C.L. as follows:
• He failed to evaluate and/or document an evaluation of patient C.L. before prescribing Ambien;
• He failed to monitor patient C.L.'s insomnia and/or use of Ambien;
47. Respondent's acts and/or omissions, as set forth in paragraphs 26 through 46, constitute repeated negligent acts pursuant to section 2234, subdivision (c), of the Code. Therefore, cause for discipline exists.
THIRD CAUSE FOR DISCIPLINE
(Furnishing Drugs without Examination)
48. Respondent is subject to disciplinary action under section 2242, subdivision (a), of the Code in that he prescribed Ambien to patients J.C., L.C., A.C., and C.L. without examination. The circumstances are as follows:
49. The allegations of the First and Second Causes for Discipline are incorporated herein as if fully set forth.
50. Respondent's acts and/or omissions in the care of patients J.C., L.C., A. C., and C.L., as set forth in the First and Second Causes for Discipline, whether proven individually or jointly, constitute cause for discipline under section 2242, subdivision (a), of the Code.
FOURTH CAUSE FOR DISCIPLINE
(Excessive Prescribing)
51. Respondent committed repeated acts of clearly excessive prescribing of Ambien pursuant to section 725 ofthe Code. The circumstances are as follows:
52. The allegations ofthe First and Second Causes for Discipline are incorporated herein as if fully set forth.
53. Respondent's acts and/or omissions in the care of patients T.C., L.C., A. C., and C.L., as set forth in the First and Second Causes for Discipline, whether proven individually or jointly, constitute cause for discipline under section 725 of the Code.
FIFTH CAUSE FOR DISCIPLINE
(Furnishing Drugs to an Addict)
54. Respondent is subject to disciplinary action under section 2241 of the Code in that he prescribed Ambien, a dangerous drug, to patient J.C., whom he knew or reasonably should have known was using or would be using the controlled substance and dangerous drug for a nonmedical purpose as more particularly alleged in the First Cause for Discipline, which is incorporated herein as if fully set forth.
SIXTH CAUSE FOR DISCIPLINE
(Violation of Statutes Regulating Drugs)
55. Respondent is subject to disciplinary action under section 2238 of the Code in that he violated federal or state statutes or regulations regulating dangerous drugs or controlled substances, as more particularly alleged in the First through Fifth Causes for Discipline which are incorporated herein as if fully set forth.
SEVENTH CAUSE FOR DISCIPLINE
(Failure to Maintain Adequate and Accurate Records)
56. Respondent is subject to disciplinary action under section 2266 of the Code in that he failed to maintain adequate and accurate records relating to the provision of services to patients J.C., L.C., A.C., and C.L. The circumstances are as follows:
57. The allegations of the First and Second Causes for Discipline are incorporated herein as if fully set forth.
58. Respondent's acts and/or omissions in the care of patients J.C., L.C., A.C., and C.L., as set forth in the First and Second Causes for Discipline, whether proven individually or jointly, constitute cause for discipline under section 2266 of the Code.
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